Post-traumatic stress disorder

Post-traumatic stress disorder
Synonyms	N/A
Pronounce	N/A
Field	Psychiatry, clinical psychology
Symptoms	Disturbing thoughts, feelings, or dreams related to the event; mental or physical distress to trauma-related cues; efforts to avoid trauma-related situations; increased fight-or-flight response
Complications	Suicide; cardiac, respiratory, musculoskeletal, gastrointestinal, and immunological disorders
Onset
Duration	> 1 month with at least 1 month of symptoms for clinical diagnosis is required, while symptoms may persist from 6 months to multiple years.
Types	N/A
Causes	Exposure to a traumatic event
Risks
Diagnosis	Based on symptoms
Differential diagnosis
Prevention
Treatment	Counseling, medication, MDMA-assisted psychotherapy
Medication	N/A
Prognosis
Frequency	8.7% (lifetime risk); 3.5% (12-month risk) (US)
Deaths

Post-traumatic stress disorder world map - DALY - WHO2002

PTSD

PTSD stress brain

PTSD statistics

Depicting basic tenets of CBT

National PTSD Awareness Day

Post-traumatic stress disorder (PTSD) is a mental disorder that can develop after a person is exposed to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, or other threats on a person's life. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in how a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress but instead may express their memories through play.

Causes and risk factors

PTSD is not limited to a single type of trauma. It can develop after:

• Violence and assault: Survivors of physical attacks, sexual assault, and domestic abuse are major contributors.
• Combat and military service: Service members exposed to prolonged periods of danger and combat-related trauma often report high rates of PTSD.
• Natural disasters and accidents: Survivors of earthquakes, hurricanes, fires, and motor vehicle accidents may also experience PTSD.
• Chronic stress or ongoing trauma: Living in a war zone, enduring long-term abuse, or experiencing repeated traumatic events can increase the risk of developing PTSD.

Certain risk factors make some individuals more likely to develop PTSD, including:

• A history of prior trauma or mental health conditions.
• A lack of social support or coping mechanisms.
• Genetic predisposition to anxiety or depression.

Symptoms

PTSD symptoms generally fall into four broad categories, each contributing to the condition’s complexity:

1. Intrusive symptoms:

• Recurrent, distressing memories of the trauma.
• Flashbacks or a feeling of reliving the event.
• Intense emotional and physical reactions to reminders of the trauma.

2. Avoidance behaviors:

• Efforts to steer clear of places, people, or activities that bring up memories of the trauma.
• Avoidance of thoughts or feelings related to the traumatic experience.

3. Negative changes in mood and cognition:

• Persistent negative thoughts about oneself or the world.
• Guilt, shame, or fear.
• Difficulty recalling key details of the trauma.
• A sense of detachment from others.

4. Hyperarousal and reactivity:

• Being easily startled or feeling constantly on edge.
• Irritability and anger outbursts.
• Trouble concentrating or sleeping.

Diagnosis

The diagnosis of PTSD involves meeting specific clinical criteria established by mental health professionals. These include:

• Exposure to trauma:
• Direct experience of a traumatic event.
• Witnessing the event happening to others.
• Learning about traumatic events affecting close family or friends.
• Repeated or extreme exposure to aversive details of trauma (e.g., first responders handling human remains).

• Symptom presentation:
• Symptoms must persist for more than one month.
• The individual must experience significant distress or functional impairment.

• Assessment tools:

Structured interviews and validated scales, such as the Clinician-Administered PTSD Scale (CAPS) or the PTSD Checklist (PCL), help determine the severity and impact of symptoms.

Treatment

Effective treatments for PTSD focus on reducing symptoms, improving quality of life, and helping individuals regain a sense of control. These include:

• Psychotherapy:
• Cognitive-behavioral therapy (CBT): Identifies and changes negative thought patterns.
• Prolonged Exposure Therapy: Gradually confronts trauma-related memories to reduce avoidance and emotional distress.
• Eye Movement Desensitization and Reprocessing (EMDR): Combines guided eye movements with memory processing to alleviate distress.

• Medications:
• Selective serotonin reuptake inhibitors (SSRIs), such as sertraline and paroxetine, are commonly prescribed.
• Prazosin may be used off-label for nightmares and sleep disturbances.

• Lifestyle and social support:
• Encouraging healthy routines, mindfulness practices, and building a strong support system all contribute to recovery.

Prevention

Efforts to prevent PTSD often center on early intervention and support following a traumatic event. While not all cases are avoidable, certain measures may reduce the risk of developing chronic symptoms:

• Early psychological intervention: Providing immediate emotional support and practical assistance can help trauma survivors process their experiences and feel less overwhelmed.
• Building resilience: Encouraging healthy coping strategies, social connections, and access to mental health resources can strengthen an individual’s ability to recover from traumatic events.
• Education and awareness: Teaching at-risk populations—such as military personnel or first responders—about the signs of PTSD and available support services can facilitate early recognition and prompt treatment.

Prognosis

The course of PTSD varies widely among individuals, depending on the severity of symptoms, the presence of co-occurring conditions, and the quality of treatment. Some individuals experience significant improvement within months of starting therapy, while others may require ongoing support and management.

• Factors influencing recovery:
• Access to evidence-based treatment, such as cognitive-behavioral therapy or EMDR.
• Strong social support from family, friends, and community resources.
• A personal commitment to follow through with therapy and self-care practices.

• Long-term outlook:
• Many individuals with PTSD experience substantial symptom relief over time.
• Those who maintain active engagement in therapy and supportive relationships often regain a high quality of life.
• Some people may continue to experience residual symptoms, but these can often be managed effectively with ongoing treatment and coping strategies.

Role of support systems

Social support plays a vital role in both the prevention and treatment of PTSD. Positive relationships and a strong network of family, friends, and community resources can:

• Alleviate emotional distress: Having someone to confide in and rely on helps reduce feelings of isolation and shame.
• Encourage treatment adherence: Supportive individuals can motivate someone with PTSD to attend therapy sessions, follow medical advice, and engage in self-care.
• Provide practical assistance: In the aftermath of trauma, friends and family may help with everyday responsibilities, creating a more stable environment for recovery.

Community organizations, peer support groups, and online forums also contribute by offering shared experiences, educational resources, and a safe space to discuss struggles and successes.

Integrating PTSD treatment into healthcare

As awareness of PTSD continues to grow, there is an increasing emphasis on incorporating mental health services into general medical care. Key approaches include:

• Primary care screening: Routinely screening patients for PTSD in primary care settings can help identify those in need of early intervention.
• Integrated care models: Bringing together mental health professionals, primary care physicians, and social workers in a coordinated care team ensures that individuals with PTSD receive comprehensive treatment.
• Trauma-informed care in medical facilities: Training healthcare staff to recognize trauma-related symptoms and to approach care with sensitivity improves outcomes and patient satisfaction.
• Telehealth services: Expanding access to therapy and support through video consultations and online resources increases the reach of evidence-based treatments.

By embedding PTSD treatment into the wider healthcare system, it becomes easier to identify at-risk individuals, offer timely interventions, and reduce the long-term impact of the disorder.

Frequently Asked Questions

Many people have questions about PTSD, its causes, and its treatment. Below are answers to some of the most commonly asked questions:

What makes someone more likely to develop PTSD? Not everyone who experiences trauma develops PTSD. Factors that increase risk include multiple traumatic exposures, a history of mental health conditions, limited social support, and genetic predisposition.

How long does it take to recover from PTSD? Recovery times vary widely. Some individuals respond well to short-term therapy, while others may need months or years of treatment and ongoing support to manage their symptoms effectively.

Can PTSD come back after treatment? While successful treatment often leads to substantial symptom reduction, stress or new traumatic events can trigger a recurrence of symptoms. Continued self-care, periodic check-ins with a therapist, and a strong support network can help maintain long-term well-being.

Is medication required to treat PTSD? Medications, such as SSRIs, can be helpful, but they are not always necessary. Many people find success through psychotherapy alone. The best treatment plan is often a combination of therapy, medication (if needed), and lifestyle changes.

What can family members do to help a loved one with PTSD? Family members can play a supportive role by listening without judgment, encouraging professional help, learning about PTSD, and helping create a stable, low-stress environment.

Glossary of PTSD terms

• Acute Stress Disorder (ASD) - A short-term mental health condition that occurs within the first month after a traumatic event, sharing many symptoms with PTSD but often resolving sooner.
• APA - American Psychological Association
• Avoidance - A symptom of PTSD in which individuals try to steer clear of thoughts, feelings, or situations that remind them of the traumatic event.
• CBI - Copenhagen Burnout Inventory
• CBT - Cognitive Behavioral Therapy, a widely used psychotherapy approach that helps individuals with PTSD and other conditions identify and change harmful thought patterns.
• CF - Compassion Fatigue
• DCoE - Defense Centers of Excellence
• Flashback - An intense memory or sensation that makes the individual feel as though they are reliving the traumatic event, a common symptom of PTSD.
• Hyperarousal - A heightened state of physiological and emotional tension often seen in PTSD, marked by increased alertness, irritability, and sleep disturbances.
• ISTSS - International Society for Traumatic Stress Studies
• Intrusive Thoughts - Unwanted, distressing thoughts or memories related to the traumatic event that repeatedly surface and cause significant distress.
• MBI - Mindfulness-Based Intervention
• ProQOL - Professional Quality of Life Scale
• Prazosin - A medication frequently used off-label to reduce nightmares and improve sleep in individuals with PTSD.
• PTSD - Posttraumatic Stress Disorder, a serious mental health condition that can develop following exposure to a traumatic event, characterized by symptoms such as flashbacks, avoidance, and hyperarousal.
• SAMHSA - Substance Abuse Mental Health Services Administration
• Selective Serotonin Reuptake Inhibitors (SSRIs) - A class of medications, such as sertraline and paroxetine, commonly used to treat PTSD symptoms by targeting underlying depression and anxiety.
• STS - Secondary Traumatic Stress
• STSS - Secondary Traumatic Stress Scale
• Trauma-Informed Care - A healthcare approach that acknowledges the impact of trauma, aiming to provide safety, trust, and empowerment to individuals with PTSD.
• Trigger - A stimulus that reminds an individual of their traumatic experience, potentially causing intense emotional or physical reactions.
• VT - Vicarious Traumatization

See also

• Complex post-traumatic stress disorder
• Trauma model of mental disorders
• War veteran

External links

• National Institute of Mental Health - Post-Traumatic Stress Disorder

Classification	ICD-10: F43.1 MeSH: D013313 DiseasesDB: 33846
External resources	MedlinePlus: 000925 eMedicine: med/1900

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